Massachusetts has struck a multi-billion dollar deal with the federal government that Gov. Deval Patrick says will help the state move ahead with plans to overhaul the way it pays for healthcare coverage.
Massachusetts reaches deal on $26.7 billion Medicaid waiver
Patrick praised the three-year, $26.7 billion Medicaid waiver — a $5.7 billion increase over the previous waiver.
Patrick said the money will help the state preserve existing eligibility and benefit levels in Medicaid and Commonwealth Care programs. Commonwealth Care is the subsidized insurance program established by the state's landmark 2006 healthcare law.
"Massachusetts has proven itself as a national leader in healthcare reform, with more than 98% of our residents insured," Patrick said Tuesday. "This new federal agreement will help us build on our success and tackle the next phase of our work — cracking the code on healthcare costs."
State lawmakers are hoping to tackle the healthcare spending issue in the new year. Ensuring the state can continue to pay for the coverage mandated by the 2006 law is critical to its long-term success, supporters say.
During the three-year period, the state has also agreed to fully implement the Patient Protection and Affordable Care Act, President Barack Obama's healthcare overhaul, whose major provisions go into effect on Jan. 1, 2014.
The agreement includes funding for several new health-related programs.
The waiver includes $120 million in new federal dollars to help the state's so-called "safety net hospitals" — those hospitals that treat a disproportionate share of individuals covered by Commonwealth Care and MassHealth, the state's Medicaid program.
The goal of the federal funding is to help those hospitals and similar primary care providers to move away from a fee-for-service model of care — where doctors are paid per operation, for example — and toward a model that rewards hospitals and doctors for helping keep patients healthy.
Another program funded by the deal will let the state try to curb the growing problem of pediatric asthma by covering services not traditionally paid for under insurance plans.
Those services include home visits by community home health workers and paying for the cost of supplies aimed at easing environmental factors in the home that can trigger asthma attacks.
The deal will also help the state create an "express lane eligibility program" to make it easier to renew eligibility for parents with children who are enrolled in the food stamp program. About 140,000 MassHealth members may be eligible for the express lane renewal program.
The agreement also includes more than $500 million annually for Commonwealth Care and the Health Safety Net — the program that helps reimburse hospitals for the cost of caring for the uninsured — and more than $300 million annually in other federal help to pay for services to low income and uninsured populations.
Early intervention programs, including programs aimed at helping children with autism, are also funded by the agreement.
Cindy Mann, deputy administrator of the CMS, also praised the deal, saying it will help Massachusetts continue to make progress on expanding health coverage by testing new ideas.
"The demonstration will support the Commonwealth's delivery and payment reforms while also helping it to move forward on several innovative new programs," Mann said in a statement. "We are pleased to be able to support these important initiatives."
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